Rubber-dam – a blessing not only in the Covid-19 era

It is one of the big mysteries in adhesive dentistry that REFERENCES

the majority of dentists all over the world seem to per- r
ceive rubber-dam as burdensome obligation. Although
1. Castro AS, Maran BM, Gutiérrez MF, Martini EC, Dreweck FD, Mendez-
the benefits of rubber-dam application are taught in Bauer L, Reis A, Loguercio AD. Dentin moisture does not influence
every dental school, even in the course of thousands of postoperative sensitivity in posterior restorations: A double-blind
randomized clinical trial. Am J Dent 2020;33:206–212.
CE lectures held by hundreds of opinion leaders, it has
2. Heintze SD, Rousson V. Clinical effectiveness of direct class II
not been possible to significantly change this. From our restorations – a meta-analysis. J Adhes Dent 2012;14:407–431.
point of view, it is rather simple – it is so much easier to 3. Mahn E, Rousson V, Heintze S. Meta-analysis of the influence of bonding
perform adhesive dentistry properly under rubber-dam parameters on the clinical outcome of tooth-colored cervical restorations.
J Adhes Dent 2015;17:391–403.
application. Period. It is an excellent standard, used in 4. Müller LK, Heider J, Frankenberger R, Graetz C, Jatzwauk L, Nagaba J,
several cutting-edge clinical papers all over the globe.5 Brodt R, Hussein RJ, Weber A, Voss K, Tröltzsch M, Al-Nawas B: Guide-
Of course, it’s not how you isolate the working field line: Dealing with aerosol-borne pathogens in dental practices. Dtsch
Zahnärztl Z Int 2020;2:240–245.
that’s most important, but that you isolate it, and this is 5. Peumans M, Venuti P, Politano G, Van Meerbeek B. Effective protocol for
just easier when you use rubber-dam. And to be honest, daily high-quality direct posterior composite restorations. The interdental
given a certain number of resin composite restorations anatomy of the class-2 composite restoration. J Adhes Dent 2021;34:21–34.
6. Samaranayake LP, Fakhruddin KS, Buranawat B, Panduwawala C.
placed, 50% with and 50% without rubber-dam, which The efficacy of bio-aerosol reducing procedures used in dentistry: a
group performs better? systematic review. Acta Odontol Scand 2021;79:69–80.
Rubber-dam detractors have always argued that it is
too time-consuming and that there is too little evidence in
favor of our paradigm that adhesive dentistry using rubber-
dam is clinically more effective. One could argue that there
is evidence that moisture does not affect bonding,1 but
this particular clinical trial was of course conducted under
rubber-dam isolation.1 Although there are enough hints in
the pertinent literature,2,3 the majority of dental practition-
ers still weren’t convinced of the benefits.
It seems unbelievable that a virus only 150 nanometers
in size has been able to change this view completely. To-
day, rubber-dam is perceived as a blessing and protective
shield for the restorative dentist,4,6 and if patients liked
rubber-dam before, today they love it.

Roland Frankenbergerr Bart Van Meerbeek

Vol 23, No 1, 2021 3

Copyright of Journal of Adhesive Dentistry is the property of Quintessence Publishing
Company Inc. and its content may not be copied or emailed to multiple sites or posted to a
listserv without the copyright holder's express written permission. However, users may print,
download, or email articles for individual use.